Health

Foster care kids put on too many psych drugs, report says

Many children in foster care are being overmedicated with antipsychotic drugs they may not really need, or the drugs are being given incorrectly, according to a government review obtained by CBS News.

The report by the Inspector General for the Department of Health and Human Services looked at concerns surrounding the use of these powerful drugs in children on Medicaid. Many children on Medicaid are in the foster care system.

"Psychotropic drugs are being used in these children, and we don't really know what the side effects are in children this young," said CBS News correspondent Anna Werner. "There's not a lot of research because you can't really test these drugs on children."

The report looked at a class of prescription medications called second-generation antipsychotics. Five of the drugs -- aripiprazole, olanzapine, paliperidone, quetiapine fumarate, and risperidone -- have been approved by the FDA for use in children to treat schizophrenia, bipolar disorder and irritability associated with autism.

But the OIG said in many cases, they're being given inappropriately. "When doctors (conducting the review on behalf of the Inspector General) reviewed these cases they found quality-of-care concerns in 67 percent of the cases that they looked at," Werner said.

More than half the time, the review found children on these powerful drugs were not being monitored adequately. A quarter of them were given the wrong dose. Many were given too many drugs or took them for too long.

HHS/OIG analysis of Medicaid claims in five States, 2014

"What the experts tell us is... not enough resources are really directed at taking care of these kids and giving them the therapies and the intensive treatment that they need -- not drugs," Werner said. "That's a lot of time, that's a lot of people to do that -- therapists and counselors and doctors -- and that of course all costs money."

Instead, states are opting to just put kids on drugs instead.

Dr. Fernando Siles, a child psychiatrist who treats children on Medicaid in Texas and has written thousands of prescriptions for such drugs, told Werner he doesn't have a lot of other options. He said children from troubled homes often have anger and aggression issues and he often prescribes drugs to "contain" their behaviors so they won't get bounced from foster home to foster home.

Werner's reporting also turned up the troubling case of a four-year-old boy who was put on four different psychiatric medications in the foster care system. When his grandmother gained custody a year later, she said the boy seemed like a completely different child and was suffering from terrifying hallucinations. He has since been taken off all the drugs, but still has nightmares at the age of 10.

Werner reports a number of states, including Texas, have taken steps to reduce the use of these drugs in foster children. But experts say more progress is needed, along with greater oversight of the system.